Overview NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Cohort II...

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Overview

NIATx-SI Business Practices for the Future Learning Collaborative

Fee-for-Service Cohort IIConvener Call

Jeanne Pulvermacher, Project Director

Funding provided by: CSAT

NIATx Staff

Co-Deputy Directors

Kim Johnson and Todd Molfenter Co-Executive Sponsors for the project Oversees Contract and Budget Assist with curriculum development

NIATx Staff

Project Manager – Jeanne Pulvermacher Oversees the entire project Primary liaison with funder Sends out communication and

announcements Coach support and communication

NIATx Staff

Educational Services Director – Amy McIlvaine Develop content and curriculum for webinars

and meetings Primary Liaison with Technical Experts Web Resources and Blog content

NIATx Staff

Outreach Specialist – Helena Gilbertson Coordinates webinar and call information NIATx Liaison for planning and meeting details

for face to face meetings

Seven regional teams chosen and assigned to one of two levels in the NIATx Fee-for-Service Capacity Pyramid:

Ideally each provider in a team will fit in the same level.

Fee-for-Service OBJECTIVES

Develop the capacity to bill third-party payers. Training on the core components of implementing

third-party billing systems

Identify common areas where billing systems function poorly

Learn improvement techniques that work

Know and understand The NIATx Third-party Billing Guide

Level IAim = Design a third-party billing system

• Routinely request insurance cards and verify coverage

• Request prior authorization and document authorization limits

• Provide and document services using correct billing codes and amounts

• Submit at least six invoices for payment, noting if bill was paid, denied or no response given

• Make corrections and resubmit

• Document the billing procedure for those steps and write up a policy and procedure to be included in the agency billing manual

Level II Aim = Improve Collections

• Perform a walk-through of their billing process

• Create a flow chart and assign staff to each process

• Work to improve at least one step in their process (utilization review, accuracy of record keeping) and increase collections

• Increase collections by a specified amount (will vary by provider)

• Document the billing procedures and include all policies and procedures in a billing manual

Insert Prezi

Level 12 minute Introductions

• Derrick West-Sonoma County Department of Health Services, Behavioral Health Division , City, State

Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Level 12 minute Introductions

• Mary Booker-Florida Alcohol and Drug Abuse Association (FADAA, City, State

Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Level 12 minute Introductions

• Kelley Hobbs-NH Alcohol and Other Drug Service Providers Assn.

City, State

Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Level 22 minute Introductions

• DeAnn Decker-Iowa Department of Public Health/Division of Behavioral Health, City, State

Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Level 22 minute Introductions

• Lynn Posze-Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, City, State

Coach:

• Financial and reimbursement structure in your state – key points

• Name 2 things that are keeping you awake at night

Level 22 minute Introductions

• Mollie Green-Department of Human Services, Division of Mental Health and Addiction Services (DHS DMHAS), City, State

Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Level 22 minute Introductions

• Mark Drennan-WV Behavioral Healthcare Providers Association, City, State Coach:

• Financial and reimbursement structure in your state

key points

• Name 2 things that are keeping you awake at night

Timeline

Dates Activity Format Who participates?

October 2011 Convener Pre-work and Orientation to Collaborative

Webinar Conveners, NIATx

November 2011 Coaches Pre-work and Orientation to Collaborative

Webinar Coaches, NIATx

December 2011 Kick-Off Meeting Face-to-face in each region

Coaches, Conveners, Providers, NIATx

December 2011-August 2012

Demonstration Period Monthly Interest Circle Calls. Coaching Assistance , Skill Building Calls

Coaches, Conveners, Providers, NIATx

Timeline

Dates Activity Format Who participates?

April 2012 Mid-Project Review Webinar Coaches, Conveners, Providers, NIATx

August 2012 Wrap-Up Webinar Coaches, Conveners, Providers, NIATx

September 2012 Conclusion Meeting Face-to-face meeting, location TBA

Coaches, Conveners, NIATx

1.5 day Kick-Off MeetingNovember-December 2011

• Meetings typically take place at a convener’s or provider’s office building.

• Convener responsible for securing the meeting space and other local costs associated with the meeting.

• NIATx staff, coaches, conveners, and providers will attend

Providers will learn:– NIATx Process Improvement 101,

– System design and change strategies

– Review the NIATx Third-party Billing Guide.

• Each team will develop an organization-specific “Business Practice Implementation Plan.”

Secure the meeting space

• Invite providers – 2-3 people from each site

• Reserve a meeting space and audio visual equipment

• NIATx will send a logistics sheet to each convener

Preparing for the regional meeting

Attend the “pre-meeting” webinar call(s)1. Understanding and Filling out the Dashboard

• CFO, CEO, Directors, Executive Sponsors

2. Making the most of your NIATx coach and

Technical Assistance• Change Leaders, Change Team Members, Exec.

Sponsors, Conveners

Monthly Interest Circle Calls

Each level will have a content specific call 60 minutes (Presentation and Q&A) Led by content experts and peers from around the country

Demonstration Period November 2011 – August 2012

We recommend that the following people attend Convener, Change Leader, Executive Sponsor, CEO, CFO, Chang

Team Members and Accounting staff attend

In addition:• NIATx will facilitate project review and skill-building calls with coaches

and conveners. (every 4-6 weeks)

Your feedback on these calls is critical to success!

Demonstration Period November 2011 – August 2012

Coaching“Lifeline” to the project

Facilitate monthly calls to review provider’s progress

Participate on monthly interest circle and skill builder calls

Attend the face-to-face meetings

15 days of technical assistance allowed

Mid-project Review

Formal check-in and review of project outcomes Identifying timelines and milestones needed to achieve project goals.

April 2011

2 people from each region, NIATx staff and coaches will attend

Close Out Meeting & SustainabilityAugust-September 2012

• Each convener will present their change project story at an in-person closeout session. (Place TBD)

 • Each local convener and key providers from the regional team will

present their change projects during one of two scheduled webinars for all members of the collaborative.

 • Each convener will submit a completed project charter of outcomes and

outline next steps for sustainability and dissemination to at least five additional provider sites.

E--mail communication

From:

Subject: NIATx FFS I (detail webinar call reminder)

To:Cc:

Subject: NIATx FFS II (detail webinar call reminder)

From:

To:Cc:

On the NIATx website the project is calledNIATx SI: Business Practices for the Future

Web Demo

Next Steps? Next call is __________

“Understanding the Dashboard” led by Elizabeth Strauss

Schedule the kick off meeting

Coach and convener schedule a call Review expectations and project aim

Participant final rosterTemplate will be e-mailed to convener to fill out

Send back to Jeanne by ----

Contact Information

Jeanne Pulvermacher

Jeanne.pulvermacher@chess.wisc.edu

608-513-9430

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